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100 Cases in Clinical Medicine

274 Pages · 2015 · 13.63 MB · English

  • 100 Cases in Clinical Medicine

    xa0 100 CASES


    in Clinical Medicine


    xa0 100 CASES


    in Clinical Medicine


    Second edition


    P John Rees MD FRCP


    Consultant Physician and Professor of Medical Education, King’s College


    London School of Medicine at Guy’s, King’s and St Thomas’ Hospitals,


    London, UK


    James Pattison DM FRCP


    Consultant Nephrologist, Guy’s and St Thomas’ NHS Foundation Trust,


    London, UK xa0


    Gwyn Williams MD FRCP


    Emeritus Professor of Medicine, King’s College London School of Medicine at Guy’s,


    King’s and St Thomas’ Hospitals, London, UK First published in Great Britain in 2000 by Arnold


    This second edition published in 2007 by


    Hodder Arnold, an imprint of Hodder Education and a member of the Hodder Headline Group,


    338 Euston Road, London NW1 3BH


    http://www.hoddereducation.com


    Distributed in the United States of America by


    Oxford University Press Inc.,


    198 Madison Avenue, New York, NY10016


    Oxford is a registered trademark of Oxford University Press


    © 2007 P John Rees, James M Pattison and Gwyn Williams


    All rights reserved. No part of this publication may be reproduced or transmitted in any form


    or by any means, electronically or mechanically, including photocopying, recording or any


    information storage or retrieval system, without either prior permission in writing from the


    publisher or a licence permitting restricted copying. In the United Kingdom such licences are


    issued by the Copyright Licensing Agency: Saffron House, 6-10 Kirby Street, London EC1N 8TS.


    Whilst the advice and information in this book are believed to be true and accurate at the date


    of going to press, neither the authors nor the publisher can accept any legal responsibility or


    liability for any errors or omissions that may be made. In particular (but without limiting the


    generality of the preceding disclaimer) every effort has been made to check drug dosage;


    however it is still possible that errors have been missed. Furthermore, dosage schedules are


    constantly being revised and new side-effects recognized. For these reasons the reader is


    strongly urged to consult the drug companies’ printed instructions before administering any of


    the drugs recommended in this book.


    Hodder Headline’s policy is to use papers that are natural, renewable and recyclable and made


    from wood grown in sustainable forests. The logging and manufacturing processes are expected


    to conform to the environmental regulations of the country of origin.


    British Library Cataloguing in Publication Data


    A catalogue record for this book is available from the British Library


    Library of Congress Cataloging-in- xa0Publication Data


    A catalog record for this book is available from the Library of Congress


    ISBN-10 0 340 92659 7


    ISBN-13 978 0 340 92659 8


    Commissioning Editor: Fiona Goodgame


    Project Editor: Jane Tod


    Production Controller: Lindsay Smith


    Cover Designer: Laura de Grasse


    Indexer: Laurence Errington


    Typeset in 10/12 RotisSerif by Charon Tec Ltd (A MacMillan Company), Chennai, India


    www.charontec.com


    Printed and bound in Spain


    What do you think about this book? Or any other Hodder Arnold title?


    Please visit our website at www.hoddereducation.com CONTENTS


    Preface vii


    Acknowledgements ix


    Abbreviations xi


    Section 1: Systems-related cases 1


    Cardiology 3


    Respiratory 9


    Abdomen 14


    Liver 19


    Renal 23


    Endocrinology 27


    Neurology 33


    Rheumatology 37


    Haematology 43


    Infection 47


    Section 2: General self-assessment cases 53


    Index 257


    xa0 This page intentionally left blank


    xa0 PREFACE


    Most doctors think that the most memorable way to learn medicine is to see patients. It is


    easier to recall information based on a real person than a page in a textbook. Another


    important element in the retention of information is the depth of learning. Learning that


    seeks to understand problems is more likely to be accessible later than superficial factual


    accumulation. This is the basis of problem-based learning, where students explore prob-


    lems with the help of a facilitator. The cases in this book are designed to provide another


    useful approach, parallel to seeing patients and giving an opportunity for self-directed


    exploration of clinical problems. They are based on the findings of history taking and


    examination, together with the need to evaluate initial investigations such as blood inves-


    tigations, X-rays and ECGs.


    These cases are no substitute for clinical experience with real patients, but they provide a


    safe environment for students to explore clinical problems and their own approach to


    diagnosis and management. Most are common problems that might present to a general


    practitioner’s surgery, a medical outpatients or a session on call in hospital. There are a


    few more unusual cases to illustrate specific points and to emphasize that rare things do


    present, even if they are uncommon. The cases are written to try to interest students in


    clinical problems and to enthuse them to find out more. They try to explore thinking


    about diagnosis and management of real clinical situations.


    The first 20 cases are arranged by systems, but the next 80 are in random order since, in


    medicine, symptoms such as breathlessness and pain may relate to many different clinical


    problems in various systems. We hope you enjoy working through the problems presented


    here and can put the lessons you learn into practice in your student and subsequent career.


    P John Rees


    xa0


    James Pattison


    Gwyn Williams


    January 2007 This page intentionally left blank


    xa0 ACKNOWLEDGEMENTS


    The authors would like to thank the following people for their help with illustrations:


    Dr A Saunders, Dr S Rankin, Dr J Reidy, Dr J Bingham, Dr L Macdonald, Dr G Cook,


    Dr T Gibson, Professor R Reznak, Dr B Lams, Dr J Chambers, Dr H Milburn and Dr J Gilmore.


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